Can This Patient Read and Understand Written Health Information?

Powers, Benjamin; Trinh, Jane V.; Bosworth, Hayden B.

doi:10.1001/jama.2010.896

Cited by 261 publications

(205 citation statements)

References 42 publications

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“…Studies validating this question with more commonly used tests of health literacy, including the Rapid Estimate of Adult Literacy Measure (REALM) and the Short Test of Functional Health Literacy in Adults (S-TOFHLA), have suggested a response of "somewhat confident" or less as a proxy for low health literacy. [32][33][34][35] This measure has been validated in Spanish. 36 The 2010 health literacy module also included the revised, shortened version of the Rapid Estimate of Adult Literacy in Medicine (REALM-R); we followed established convention defining low health literacy as seven or fewer words pronounced correctly.…”

Section: Methodsmentioning

confidence: 99%

Health Literacy and the Digital Divide Among Older Americans

2014

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BACKGROUND: Among the requirements for meaningful use of electronic medical records (EMRs) is that patients must be able to interact online with information from their records. However, many older Americans may be unprepared to do this, particularly those with low levels of health literacy. OBJECTIVE: The purpose of the study was to quantify the relationship between health literacy and use of the Internet for obtaining health information among Americans aged 65 and older. DESIGN: We performed retrospective analysis of 2009 and 2010 data from the Health and Retirement Study, a longitudinal survey of a nationally representative sample of older Americans. PARTICIPANTS: Subjects were community-dwelling adults aged 65 years and older (824 individuals in the general population and 1,584 Internet users). MAIN MEASURES: Our analysis included measures of regular use of the Internet for any purpose and use of the Internet to obtain health or medical information; health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine-Revised (REALM-R) and self-reported confidence filling out medical forms. KEY RESULTS: Only 9.7 % of elderly individuals with low health literacy used the Internet to obtain health information, compared with 31.9 % of those with adequate health literacy. This gradient persisted after controlling for sociodemographic characteristics, health status, and general cognitive ability. The gradient arose both because individuals with low health literacy were less likely to use the Internet at all (OR=0.36 [95 % CI 0.24 to 0.54]) and because, among those who did use the Internet, individuals with low health literacy were less likely to use it to get health or medical information (OR=0.60 [95 % CI 0.47 to 0.77]). CONCLUSION: Low health literacy is associated with significantly less use of the Internet for health information among Americans aged 65 and older. Webbased health interventions targeting older adults must address barriers to substantive use by individuals with low health literacy, or risk exacerbating the digital divide.

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Section: Methodsmentioning

confidence: 99%

Health Literacy and the Digital Divide Among Older Americans

2014

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“…First, multi-item HL tools such as the Test of Functional Health Literacy in Adults (TOFHLA) 15 and Rapid Estimate of Adult Literacy in Medicine (REALM) 16 are too lengthy to administer in busy clinical settings. 17 Second, specifically testing HL may cause patients to feel shame and/or embarrassment. 18,19 For these reasons, brief, onesentence items have been developed and tested to quickly identify in a non-threatening manner patients who are potentially at risk of having limited general HL and numeracy skills.…”

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confidence: 99%

Brief Health Literacy Screening Items Predict Newest Vital Sign Scores

Stagliano

Wallace

2013

The Journal of the American Board of Family Medicine

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Background: Numeracy is an important but understudied component of health literacy (HL). The purpose of this study was to examine the predictive ability of established general HL and numeracy screening items in estimating Newest Vital Sign (NVS) scores.Methods: We studied 241 adults attending primary care clinics in the midwestern United States. Demographic items, HL screening questions, and the NVS were administered to patients. To determine the accuracy of HL and numeracy screening items, area under the receiver operating characteristic (AUROC) curves were determined for each screening item, using NVS scores as the reference standard.Results

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“…With increasing health information available through media reports and the Internet, many health information resources are easily distributed to the general population [3]- [5]. However, adequate use of these resources depends on an individual's skill in finding and applying information about their health issues [6]. These skills have been conceptualized as health literacy (HL).…”

Section: Introductionmentioning

confidence: 99%

Age- and Sex-Specific Impact of Health Literacy on Healthy Lifestyle Characteristics among Japanese Residents in a Rural Community

Yokokawa¹,

Yuasa²,

Sanada³

et al. 2015

Health

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The study aimed to examine age-and sex-specific associations between health literacy (HL) and healthy lifestyle characteristics. The cross-sectional study was conducted to examine a total 1348 Japanese participants (613 male and 735 female) who took the health check-up program in April 2013, at Tsumagoi Village, Japan. Information was collected by self-administered questionnaire on three communicative and two critical HL items, and healthy lifestyle characteristics listed in Breslow's seven health practices. In multivariate logistic analysis, high HL (≥18) was significantly associated with healthy lifestyle characteristics in both non-elderly (<65 years old) and elderly (≥65 years old) [Odds ratio (OR) = 1.40, 95% Confidence interval (CI) = 1.13 -1.75 for non-elderly, OR = 1.34, 95% CI = 1.02 -1.76 for elderly], as well as female participants (OR = 1.43, 95% CI = 1.06 -1.94), while the significance was borderline in male participants (OR = 1.34, 95% CI = 0.96 -1.88). Among 5 HL items, the ability to extract health-related information was significantly associated with healthy lifestyle characteristics (OR = 1.52, 95% CI = 1.11 -2.07 for non-elderly, OR = 1.55, 95% CI = 1.04 -2.30 for elderly, OR = 1.95, 95% CI = 1.28 -2.97 for female participants. HDL-C concentration in the high HL group was significantly higher than that in the low HL group. Among healthy lifestyle characteristics, proportions of smoking behavior (non-smoker), exercise fre-* Corresponding author. H. Yokokawa et al. 680quency (twice or more per week), and sleep duration (7 -8 hours) were significantly higher in the high HL group than in the low HL group. The present study revealed a positive association between HL and healthy lifestyle characteristics, which suggests that people are likely to engage in health-promoting behaviours based on access and ability to understand medical information for both age groups and female participants. Significant findings among female participants may be emphasized since it's important from the entire family's perspective as women are the caretakers of the family. These findings may indicate the importance of comprehensive assessment, including HL, for health promotion in the community.

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Can This Patient Read and Understand Written Health Information?

Abstract: Several single-item questions, including use of a surrogate reader and confidence with medical forms, were moderately effective for quickly identifying patients with limited literacy.

Cited by 261 publications

References 42 publications

Health Literacy and the Digital Divide Among Older Americans

Health Literacy and the Digital Divide Among Older Americans

Brief Health Literacy Screening Items Predict Newest Vital Sign Scores

Age- and Sex-Specific Impact of Health Literacy on Healthy Lifestyle Characteristics among Japanese Residents in a Rural Community

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